Mallory Ferguson
Physical Therapist in Mound City, MO. Individual provider (NPI-1).
NPI number1346724176
StatusActive
Last updated in NPPESNov 8, 2019
Details
- NPI
- 1346724176
- Entity type
- Individual (NPI-1)
- Name
- Mallory Ferguson
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Sep 18, 2018
- Last updated
- Nov 8, 2019
Medicare and OIG
- Medicare enrolled (PECOS)
- Yes · PRACTITIONER - PHYSICAL THERAPIST IN PRIVATE PRACTICE
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 225100000X | Physical Therapist | 2005005090 | MO | Yes |
| 225100000X | Physical Therapist | PT60868468 | WA | |
| 225100000X | Physical Therapist | 005225 | IA |
Practice location
1401 Savannah StMound City, MO 64470-1539
Phone 402-301-9885
Mailing address
1401 Savannah StMound City, MO 64470-1539
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